Provider Demographics
NPI:1902497365
Name:PREMA BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:PREMA BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAILET
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-278-5903
Mailing Address - Street 1:240 W PALMETTO PARK RD STE 300C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3761
Mailing Address - Country:US
Mailing Address - Phone:786-278-5903
Mailing Address - Fax:
Practice Address - Street 1:1600 S DIXIE HWY STE 405
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7454
Practice Address - Country:US
Practice Address - Phone:786-508-3245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL832158Medicaid